Device and method to discriminate between supraventricular tachycardias and ventricular arrhythmias

Abstract

This invention provides a method to discriminate between ventricular arrhythmia and supraventricular tachycardia by detecting an earliest arriving electrical signal following antitachycardia pacing. Also disclosed is an implantable cardiac defibrillator that is capable of simultaneous atrioventricular anti-tachycardia pacing bursts and detecting an earliest arriving electrical signal. The discrimination capability reduces the incidence of inappropriate shocks from dual-chamber implantable cardiac defibrillators to near zero and provides a method to differentially diagnose supraventricular tachycardia from ventricular tachycardia.

1. An implantable cardiac defibrillator device, comprising:
 a) an implantable pacemaker, wherein said pacemaker is configured to generate simultaneous anti-tachycardia pacing bursts such that said pacing bursts generate a blanking period; 
 b)an atrial lead and a ventricular lead attached to said device, said atrial lead and said ventricular lead further comprising distal tip electrodes configured to deliver said simultaneous anti-tachycardia pacing bursts and detect an earliest arriving electrical signal and wherein said implantable cardiac defibrillator device is configured to determine said earliest arriving electrical signal following said blanking period wherein said earliest arriving electrical signal diagnoses an origin of an arrhythmia; and 
 c) a timing device connected to said pacemaker, said timing device configured to identify that said diagnosed origin of an arrhythmia is selected from between a supraventricular tachycardia, a ventricular tachycardia, and an atrioventricular nodal reentrant tachycardia, wherein said identification of said diagnosed origin of an arrhythmia is based upon said determination of said earliest arriving electrical signal. 
 
     
     
       2. The device of  claim 1 , wherein said pacemaker further comprises a microprocessor configured to initiate said pacing burst. 
     
     
       3. The device of  claim 1 , wherein said atrial lead and said ventricular lead further comprise defibrillation electrodes. 
     
     
       4. The device of  claim 3 , wherein at least one of said defibrillation electrodes is configured to convert an abnormal heart rhythm into normal sinus rhythm. 
     
     
       5. The device of  claim 1 , wherein said pacemaker further comprises a storage memory connected to said atrial and ventricular leads. 
     
     
       6. The device of  claim 1 , wherein said atrial lead and said ventricular lead are quadripolar. 
     
     
       7. The method of  claim 1 , wherein said atrial lead and said ventricular lead further comprise separate conductors. 
     
     
       8. An implantable cardiac defibrillator device, comprising:
 a) an implantable pacemaker, wherein said pacemaker is configured to generate simultaneous anti-tachycardia pacing bursts such that said pacing bursts generate a blanking period; 
 b) at least one atrial lead and at least one ventricular lead attached to said device, said at least one atrial lead and said at least one ventricular lead further comprising distal tip electrodes configured to deliver said simultaneous anti-tachycardia pacing bursts and wherein said implantable cardiac defibrillator device is configured to determine an earliest arriving electrical signal following said blanking period,  wherein said earliest arriving electrical signal diagnoses an origin of an arrhythmia; and 
 c) a timing device connected to said pacemaker, said timing device configured to identify that said diagnosed origin of an arrhythmia is selected from between a supraventricular tachycardia, a ventricular tachycardia and an atrioventricular nodal reentrant tachycardia, wherein said identification of said diagnosed origin of an arrhythmia is based upon said determination of said earliest arriving electrical signal. 
 
     
     
       9. The device of  claim 8 , wherein said pacemaker further comprises a microprocessor configured to initiate said pacing burst. 
     
     
       10. The device of  claim 8 , wherein said at least one atrial lead and said at least one ventricular lead further comprise defibrillation electrodes. 
     
     
       11. The device of  claim 8 , wherein said pacemaker further comprises a storage memory connected to said atrial and ventricular leads. 
     
     
       12. The device of  claim 8 , wherein said at least one atrial lead and said at least one ventricular lead are quadripolar. 
     
     
       13. The method of  claim 8 , wherein said at least one atrial lead and said at least one ventricular lead further comprise separate conductors.